| Forget the blood, not the stone! Microhaematuria in acute urolithiasis and the role of early CT scanning. | |
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MedLine Citation:
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PMID: 18843059 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Although urinalysis is simple and inexpensive to perform, the finding of microhaematuria on urinalysis may be unreliable for diagnosing urolithiasis. OBJECTIVE: To evaluate microhaematuria as a diagnostic marker for urolithiasis compared with low-dose unenhanced multidetector computed tomography (MDCT) as the "gold standard". SETTING: A level 1 emergency department in a tertiary referral university teaching hospital. DESIGN: Retrospective analysis. METHODS: A study was undertaken to assess whether the finding of microhaematuria was diagnostic for urolithiasis using a low-dose unenhanced MDCT-based diagnosis as the reference standard by reviewing the records of all patients who presented to the emergency department with colicky flank pain and underwent a CT scan between January 2003 and December 2005. RESULTS: Urolithiasis was present (as defined by low-dose unenhanced MDCT) in 507/638 patients (79%); 341/638 (53%) were true positive for urolithiasis, 76 (12%) were true negative, 55 (9%) were false positive and 166 (26%) were false negative. Microhaematuria as a test for urolithiasis in patients presenting to the emergency department therefore has a sensitivity, specificity, positive predictive value and negative predictive value of 67%, 58%, 86% and 31%, respectively. 58% of the urinalysis results were negative for haematuria in the subset of patients with significant alternative diagnoses. CONCLUSIONS: The sensitivity, specificity and negative predictive value of microhaematuria on urinalysis for urolithiasis using unenhanced MDCT as the reference standard were low. This suggests that, when urolithiasis is clinically suspected, unenhanced MDCT is indicated without urinalysis being a prerequisite. |
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Authors:
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K Xafis; G Thalmann; L M Benneker; C Stoupis; D J Buggy; H Zimmermann; A K Exadaktylos |
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Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article |
Journal Detail:
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Title: Emergency medicine journal : EMJ Volume: 25 ISSN: 1472-0213 ISO Abbreviation: Emerg Med J Publication Date: 2008 Oct |
Date Detail:
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Created Date: 2008-10-09 Completed Date: 2009-02-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100963089 Medline TA: Emerg Med J Country: England |
Other Details:
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Languages: eng Pagination: 640-4 Citation Subset: IM |
Affiliation:
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Department of Emergency Medicine, University Hospital of Berne, Berne 3010, Switzerland. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Early Diagnosis Emergency Service, Hospital False Negative Reactions False Positive Reactions Hematuria / etiology* Humans Middle Aged Predictive Value of Tests Retrospective Studies Sensitivity and Specificity Tomography, X-Ray Computed / methods* Urinalysis / standards* Urolithiasis / complications, diagnosis* Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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